Provider Demographics
NPI:1932449279
Name:TOBIK, SANDRA MARIE (NP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:MARIE
Last Name:TOBIK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SANDY
Other - Middle Name:
Other - Last Name:TOBIK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:37 E 28TH ST
Mailing Address - Street 2:SUITE 508
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-7919
Mailing Address - Country:US
Mailing Address - Phone:212-452-4657
Mailing Address - Fax:646-370-1951
Practice Address - Street 1:2308 30TH AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-3494
Practice Address - Country:US
Practice Address - Phone:212-452-4657
Practice Address - Fax:646-370-1951
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-24
Last Update Date:2013-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY401528363LP0808X
MO2012041202363LP0808X
TX2267363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health